The staff of a medical/surgical floor of a typical hospital is under an increasing amount of pressure. Contributing to these pressures is the pervasive nursing shortage that has translated into a lower nurse to patient ratio, with longer hours and increased overtime. As a result, errors due to oversight and the like are likely to increase. Formerly, patient vital signs data were taken by a registered nurse (RN), but now these readings are often taken numerous times per day (as many as six or more readings) by nursing aides (also referred to as Patient Care Technicians (PCTs)) who must cover more patients and often have no or little clinical training. In addition and in an effort to ease the above staffing strains, many hospitals utilize more temporary contract or “traveler” nurses who float between sites. As a result, users of the monitoring equipment are transitory and must learn new internal procedures very quickly, exacerbating the above problems.
Currently, PCTs often use a cart having a number of patient diagnostic devices that can include automated blood pressure, thermometry, and pulse oximetry apparatus used to take patient vital signs over a length of stay. As noted, a PCT may likely take six readings (or more) per day over an average hospital stay of about five days. Typically, the above devices are not integrated on a cart, but rather are arranged in a piecemeal fashion, though integrated vital sign monitoring (VSM) devices, such as those manufactured by Welch Allyn, Inc. of Skaneateles Falls, N.Y. are commonly known in the field.
Vital sign readings, when taken, are often written onto a loose worksheet or often onto scraps of paper. At the end of rounds, these readings are then copied onto the patient's chart on a “vitals” sheet. If anomalous readings are detected, the RN is notified. Otherwise, the RN is usually not consulted and often will not or may not get the chance to review any of the readings which have been taken.
Upon examination and if the vital signs readings are suspect in any way, the RN will often send the PCT back to the patient and request that another reading(s be taken. In the meantime, even if a significant change in the patient's vitals has been detected, time has been wasted and therefore lost. It is possible that in the current manner of testing described above, that many vital signs variations are not caught or otherwise detected or noted until the patient's condition has significantly changed.
Though the problems are arguably less involved, there are similar generalized needs in other clinical settings, such as the physician's offices, in order to be able to better conduct and document patient clinical encounters more efficiently and with better accuracy.